PURPOSE: This rule sets forth the requirements and process of application for a state grant for construction of wastewater treatment works and the terms and conditions for receipt of this grant. This rule also clarifies the requirements, the types of facilities eligible for grant funds and the grant amount available for eligible grantees.

1. (1) Applicability. This rule defines the minimum requirements which apply to all recipients of assistance under the State Forty Percent Grant Program. The recipient must satisfy more stringent requirements, if required to do so by state or local statutes, policies, rules, ordinances or orders.
2. (2) Grant Amount. With exception of planning and design phase engineering costs, the grant amount is limited to forty percent (40%) of the eligible project costs or onethird (1/3) of the annual state appropriation for this program, whichever is less. Planning and design phase engineering costs will be forty percent (40%) of the allowance as shown under subsection (6)(B).

3. (3) Eligible Applicants.

   1. (A) Eligible applicants must be a county, public sewer district, municipality or combination of the same.
   2. (B) Eligible applicants are limited to those applicants which do not qualify for a loan for the total eligible project costs under 10 CSR 20-4.042.
4. (4) Definitions. The definitions of terms for this rule are contained in 10 CSR 20-2.010 and 10 CSR 20-4.040(2)(A)–(S).

5. (5) General Grant Requirements.

   1. (A) A construction permit and an operating permit must be obtained in accordance with 10 CSR 20-6.010–10 CSR 20-6.060.
   2. (B) Acceptance of a grant constitutes agreement that cost overrun shall be borne by the applicant.
   3. (C) Provisions must be made for adequate inspection during construction by the grantee.
   4. (D) No grant will be awarded to an applicant who is in noncompliance with the monitoring or reporting requirements of a valid National Pollutant Discharge Elimination System (NPDES) permit or who is not properly operating or maintaining an existing system.
   5. (E) Project cost eligibility is limited to those listed in section (6) of this rule.

6. (6) Classification of Costs. The information in this section represents policies and procedures for determining the eligibility of project costs for assistance under programs supported by the Forty Percent Grant Program.

   1. (A) General. It is the policy of the commission that all project costs will be eligible if they meet the following tests:

      1. 1. Reasonable and cost effective;
      2. 2. Necessary for the construction of an

operable wastewater facility required mitigation; and

1. 3. Resolve water pollution problems in

existence prior to the date of grant application.

1. (B) Eligible Costs. Eligible costs include, at a minimum:

   1. 1. An allowance for engineering services

and other services incurred in planning and in preparing the design drawings and specifications for the project. An allowance for planning and design will be based on a percentage of the eligible construction, land equipment, materials and supplies cost identified in the bid documents or purchase contracts as determined from Table 1 or 2 (as applicable).

Table 1—Maximum Eligible Amount for Facilities Planning and Design Allowance as a Percentage Construction of Construction Cost $ 100,000 or less $ 120,000 $ 150,000 $ 175,000 $ 200,000 $ 250,000 $ 300,000 $ 350,000 $ 400,000 $ 500,000 $ 600,000 $ 700,000 $ 800,000 $ 900,000 $ 1,000,000 $ 1,200,000 $ 1,500,000 $ 1,750,000 $ 2,000,000 $ 2,500,000 $ 3,000,000 $ 3,500,000 $ 4,000,000 $ 5,000,000 $ 6,000,000 $ 7,000,000 $ 8,000,000 $ 9,000,000 *Interpolate between values including

Cost* 14.49 14.11 13.66 * Interpolate between values 13.36 13.10 Note: These tables shall not be used to 12.68 determine the actual compensation for facili- 12.35 ties planning or design services. The com- 12.08 pensation for facilities planning or design ser- 11.84 vices should be based upon the nature, scope 11.46 and complexity of the services required by 11.16 the community. 10.92 10.71 incurred during the building and initial oper- 10.52 ation phase of the project to ensure that it is 10.36 built in conformance with the design draw- 10.09 ings and specifications. Eligible construction 9.77 phase and initial operation phase services are 9.55 limited to— 9.37 9.07 8.83 8.63 8.47 8.20 7.98 manual; 7.81 7.66 start-up training for operators of mechanical 7.52 facilities constructed by the project to the extent that these costs are incurred prior to Table 2—Maximum Eligible Amount Design Only

Allowance as a Percentage

Construction of Construction Cost Cost* $ 100,000 or less $ 120,000 $ 150,000 $ 175,000 $ 200,000 $ 250,000 $ 300,000 $ 350,000 $ 400,000 $ 500,000 $ 600,000 $ 700,000 $ 800,000 $ 900,000 $ 1,000,000 $ 1,200,000 $ 1,500,000 $ 1,750,000 $ 2,000,000 $ 2,500,000 $ 3,000,000 $ 3,500,000 $ 4,000,000 $ 5,000,000 $ 6,000,000 $ 7,000,000 $ 8,000,000 $ 9,000,000

1. 2. The reasonable cost of services

   1. A. Office engineering;
   2. B. Construction surveillance;
   3. C. Stakeout surveying;
   4. D. As-built drawings;
   5. E. Special soils/materials testing;
   6. F. Operation and maintenance

   7. G. Follow-up services and the cost of 8.57 8.38 8.16 8.01 7.88 7.67 7.50 7.36 7.24 7.05 6.89 6.77 6.66 6.56 6.43 6.34 6.17 6.05 5.96 5.80 5.67 5.57 5.48 5.33 5.21 5.12 5.04 4.96 this department’s final inspection. Costs shall be limited to on-site operator training tailored to the facilities constructed or onor off-site training may be provided by the equipment manufacturer if this training is properly procured;

      1. H. User charge and sewer use ordi-

nance; and

1. I. Plan of operation;
2. 3. The cost of subagreements for con-

structing the facilities listed if the associated problems are not caused by inadequate operation and maintenance practices:

1. A. New interceptors;
2. B. New pump stations;
3. C. New wastewater treatment facili-

ties;

1. D. Rehabilitation or upgrading of

treatment plants;

1. E. Rehabilitation or replacement of

existing pump stations whichever is most cost effective;

1. F. Replacement of force mains and

interceptors causing regular dry weather bypassing or widespread sewer backups;

1. G. Collection sewers; and
2. H. The cost of sewer rehabilitation,

other than normal maintenance costs for reduction of excessive information/inflow (I/I);

1. 4. Change orders and the costs of meri-

torious contractor claims for increased costs under subagreements as follows:

1. A. Within the allowable scope of the

project;

1. B. Costs of equitable adjustments due

to differing site conditions; and

1. C. Settlements, arbitration awards and

court judgments which resolve contractor claims shall be allowable only to the extent that they are not due to the mismanagement of the recipient;

1. 5. Costs necessary to mitigate only

direct, adverse, physical impacts resulting from building of the treatment works;

1. 6. The costs of site screening necessary

to comply with environmental studies and facilities plans or necessary to screen adjacent properties;

1. 7. The cost of groundwater monitoring

facilities necessary to determine the possibility of groundwater deterioration, depletion or modification resulting from building the project;

1. 8. Equipment, materials and supplies.

   1. A. The cost of a reasonable inventory

of laboratory chemicals and supplies necessary to initiate plant operations and laboratory items necessary to conduct tests required for plant operation.

1. B. Cost of shop equipment installed at

the treatment works necessary to the operation of the works.

1. C. The costs of necessary safety

equipment, provided the equipment meets applicable federal, state, local or industry safety requirements.

1. D. The costs of mobile equipment

necessary for the operation of the overall wastewater treatment facility, transmission of wastewater or sludge or for the maintenance of equipment. These items include:

1. (I) Portable standby generators;
2. (II) Large portable emergency

pumps to provide pump-around capability in the event of pump station failure or pipeline breaks;

1. (III) Trailers and other vehicles

having as their purpose the transportation and/or application of liquid or dewatered sludge or septage; and

1. (IV) Replacement parts identified

and approved in advance;

1. 9. Costs of royalties for the use of or

rights in a patented process or product with the prior approval of the department;

1. 10. Land or easements when used as an

integral part of the treatment process;

1. 11. Purchase of private wastewater treat-

ment systems, excluding collector and interceptor sewers, provided the project will upgrade the existing facilities; and

1. 12. Force account work for construction

oversight.

1. (7) Project Selection Process. Priority will be based upon the priority system established in 10 CSR 20-4.010.

   1. (A) The commission shall hold an annual competition for receipt of state grant assistance.
   2. (B) Applicants must submit an application as described in section (8) of this rule on or before November 15 prior to the fiscal year for which state grant assistance is being sought. Unsuccessful applicants requesting funds during a given fiscal year shall be considered for funding the next fiscal year and need not reapply. This deadline may be extended by the commission if inadequate applications are received.
   3. (C) All qualified applications will be rated and placed on the planning list in accordance with 10 CSR 20-4.010(1)(A).
   4. (D) The commission will select the highest rated projects for state grant assistance from state grant funds anticipated to be available during the upcoming fiscal year. However, if a fundable high priority project has not been submitted, approval obtained on all documents required for a state grant and obtained the primary source of funding (sixty percent 10 CSR 20-4

(60%) local share) within two (2) years of being placed on the fundable list, it shall be removed from the fundable list on November 15 of the second year. All allocated grant funds will be recovered and combined with any available regular grant funds in the next Intended Use Plan.

1. (8) Application Requirements. Applicants must submit the documents listed in the following subsections (8)(A)–(D) to be considered for inclusion on the priority list. Some documents may be waived by the department if justified—

   1. (A) An application form;

   2. (B) A project summary which includes:

      1. 1. The need for the project;
      2. 2. The project components including

maps or drawings showing the project location and layout; and

1. 3. A cost estimate including a cost

breakdown;

1. (C) Draft financial capability analysis prepared in accordance with paragraph (9)(B)4. of this rule; and

2. (D) Proposed project schedule. The following represents the minimum requirements for the project schedule:

   1. 1. Construction start defined as date of

issuance of notice to proceed;

1. 2. Construction completion;
2. 3. Initiation of operation; and
3. 4. Project completion.

1. (9) Requirements Preceding Bidding Authorization. In addition to the requirements of section (8) of this rule, applicants must submit the documents listed in subsection (9)(A)–(J) and obtain departmental approval prior to award of grant funds.

   1. (A) A facility plan prepared in accordance with section (14) of this rule must be submitted by September 1 of the fiscal year for which funds are being requested.
   2. (B) Resolution identifying the Authorized Representative. Applicants for assistance under the State Forty Percent Grant Program shall provide a resolution by the governing body designating a representative by name authorized to file the application for assistance.
   3. (C) Plans and specifications.
   4. (D) Financial Capability Analysis. The applicant, along with its application, shall submit written certification that the applicant has analyzed the costs and financial impacts of the proposed facilities and; that the applicant has the capability to finance and manage the construction and operation of the facilities. The wastewater facilities’ financial information sheet shall be submitted with the certification.
   5. (E) Draft engineering contract as described in section (11).
   6. (F) Draft user charge ordinance as described in section (17).
   7. (G) Draft sewer use ordinance as described in section (17).

   8. (H) Updated Project Schedule, if Required. The following represents the minimum requirements for the project schedule:

      1. 1. Construction start defined as date of

issuance of notice to proceed;

1. 2. Construction completion;
2. 3. Initiation of operation; and
3. 4. Project completion.
4. (I) Certification of Easements and Real Property Acquisition. Recipients of assistance under the state grant program shall have obtained title or option to the property or easements or condemnation proceedings initiated for the project prior to award of a grant.
5. (J) Other information or documentation deemed necessary by the applicant or the department to ensure the proper expenditure of state funds.

1. (10) Accounting and Audits. Applicants are required to have an adequate financial management system and audit procedure for the project which provides efficient and effective accountability and control of all property, funds and assets related to the project. The applicant’s financial system is subject to state audits to assure fiscal integrity of public funds.

2. (11) Architectural or Engineering Contracts. The following represents the minimum requirements for the architectural or engineering contracts:

   1. (A) General requirements for subagreements are, that they—

      1. 1. Be necessary for and directly related

to the accomplishment of the project work;

1. 2. Be in the form of a bilaterally execut-

ed written agreement;

1. 3. Be for monetary consideration;
2. 4. Not be in the nature of a grant or gift;
3. 5. State a time frame for performance;
4. 6. State a cost which cannot be exceed-

ed except by amendment; and

1. 7. State provisions for payment; and

2. (B) The nature, scope and extent of work to be performed during construction should include, but not be limited to, the following:

   1. 1. Preparing a plan of operation if

required by the department and as defined in subsection (20)(A);

1. 2. Preparing an operation and mainte-

nance manual if required by the department and as defined in subsection (20)(B);

1. 3. Assisting the recipient in bid letting;
2. 4. Assisting the recipient subdivision in

reviewing and analyzing construction bids and making recommendations for award; and

1. 5. Inspecting during construction to

ensure conformance with the construction contract documents unless waived by the department.

1. (12) Procurement of Engineering Services. It is the policy of the commission that contracts for architectural, engineering and land surveying services be negotiated on the basis of demonstrated competence, qualifications for the type of services required and at fair and reasonable prices. The procedures listed in subsections (12)(B) and (C) are contained in sections 8.285–8.291, RSMo.

   1. (A) Use of the Same Architect or Engineer During Construction. If the recipient is satisfied with the qualifications and performance of the architect or engineer who provided any or all of the facilities planning or design services for the project and wishes to retain that firm or individual during construction of the project, it may do so without further evaluation of qualifications, provided the recipient selected the firm using at a minimum the procedures outlined in subsections (12)(B) and

2. (C) of this rule.

   1. (B) Whenever a project requiring architectural, engineering or land surveying services is proposed, the owner shall evaluate current statements of qualifications and performance data of prequalified firms on file together with those that may be submitted by other firms regarding the proposed project. In evaluating the qualifications of each firm, the owner shall use the following criteria:

      1. 1. The specialized experience and tech-

nical competence of the firm with respect to the type of services required;

1. 2. The capacity and capability of the

firm to perform the work in question, including specialized services, within the time limitations fixed for the completion of the project;

1. 3. The past record of performance of the

firm with respect to such factors as control of costs, quality of work and ability to meet schedules; and

1. 4. The firm’s proximity to and familiar-

ity with the area in which the project is located.

1. (C) Negotiation of a Contract.

   1. 1. The recipient shall list three (3) high-

ly qualified firms. The recipient then shall select the firm considered best qualified and capable of performing the desired work and attempt to negotiate a contract for the project with the firm selected.

1. 2. For a basis for negotiations, the recip-

ient shall prepare a written description of the scope of the proposed services.

1. 3. If the recipient is unable to negotiate

a satisfactory contract with the firm selected, negotiations with that firm shall be terminated. The owner then shall undertake negotiations with another of the qualified firms selected. If there is a failing of accord with the second firm, negotiations with the firm shall be terminated. The recipient then shall undertake negotiations with the third qualified firm.

1. 4. If the recipient is unable to negotiate

a contract with any of the selected firms, the recipient shall reevaluate the necessary architectural, engineering or land surveying services, including the scope of services and reasonable fee requirements, again compile a list of qualified firms and proceed in accordance with the provisions of subsections (12)(B) and (C).

1. (13) Public Participation. The public must be allowed an opportunity to exchange ideas with the applicant during project development. Public participation must be preceded by timely distribution of information and must occur sufficiently in advance of decision making to allow the recipient to assimilate public views into action. At a minimum, the recipient must provide an opportunity for public participation, prior to approval of the facility plan and draft user charge ordinance, at a public meeting at which the proposed alternative and the proposed user charge rates are discussed. The recipient shall prepare a transcript, recording or other complete record of the proceeding and submit it to the department and make it available at no more than cost to anyone who requests it. A copy of the record should be available for public review.

2. (14) Facility Planning. Facility plans or engineering reports must be in accordance with accepted engineering practices, the current Waste Treatment Design Guide, 10 CSR 20- 8.

   1. (A) The most reasonable environmentally sound and implementable waste management alternatives must be studied and evaluated. Proposed waste treatment management plans and practices shall provide for the cost-effective technology that can treat wastewater and nonexcessive I/I to meet the applicable NPDES requirements.
   2. (B) An I/I analysis must be included which indicates whether the sewer system is affected by excessive I/I and if so an analysis which determines the cost-effective solution to the excessive I/I.
   3. (C) An estimate of the average user charge including documentation of the basis of the estimate.
   4. (D) An evaluation of the impact of the proposed project on the environment is required.
3. (15) Design. Design of the project will be in conformance with accepted engineering practices and the current Waste Treatment Design Guide, 10 CSR 20-8. A preliminary design submittal, including the design criteria and facilities layout sheet, may be required at approximately the twenty percent (20%) design stage.
4. (16) Intermunicipal Agreements. If the project serves two (2) or more public entities, the applicant shall submit executed agreements or contracts between the public entities for the financing, construction and operation of the proposed treatment facilities.

5. (17) User Charge and Sewer Use Ordinance. Recipients are required to adopt and implement, for the useful life of the treatment works, approved user charge and sewer use ordinances.

   1. (A) The user charge system must be designed to produce adequate revenues required for the operation and maintenance, including a reserve for replacement. Each user charge system must include an adequate financial management system that will accurately account for revenues generated by the system, debt service and expenditures for operation and maintenance based on an adequate budget identifying the basis for determining the annual operation and maintenance costs and the costs of personnel, material, energy and administration. The system shall provide for an annual review of charges. A system shall be adopted by all political subdivisions receiving service from the recipient.
   2. (B) The sewer use ordinance shall prohibit any new connections from inflow sources into the treatment works and require that new sewers and connections to the treatment works are properly designed and constructed. The ordinance shall also require that all wastewater introduced into the treatment works not contain toxic or other pollutants in amounts or concentrations that endanger public safety and physical integrity of the treatment works cause, violation of effluent or water quality limitations, preclude the selection of the most cost-effective alternative for wastewater treatment and sludge disposal or inhibit the performance of a pretreatment facility. The ordinance shall require the recipient to notify all potential users of service availability and that all users shall connect to the system within ninety (90) days of notice of service availability.
   3. (C) At ninety percent (90%) construction completion, the final user charge and sewer use ordinances, as approved, shall be implemented.

6. (18) Specifications. The construction specifications must contain the features listed in subsections (18)(A)–(M).

   1. (A) The project must be advertised for thirty (30) days between the time the notice is published and when bids are opened. The public notice should be published in an area newspaper of general circulation and/or contractors’ publications.
   2. (B) In accordance with section 71.140, RSMo, preference shall be given to Missouri products.
   3. (C) Pursuant to section 34.076, RSMo, a preference shall be given to those persons doing business as Missouri firms, corporations or individuals, or which maintain Missouri offices or places of business, when the quality of performance promised is equal or better and the price quoted is the same or less. In addition, in order for a nondomiciliary bidder to be successful, his/her bid must be that same percentage lower than a domiciliary Missouri bidder’s bid as would be required for a Missouri bidder to successfully bid in the nondomiciliary’s state. Any bidder domiciled outside the boundaries of Missouri shall submit an audited financial statement as would be required of a Missouri domiciled contractor or bidder on a bid being let in the domiciliary state of that contractor or bidder.
   4. (D) The proposal form must contain a nondiscrimination statement.
   5. (E) Each bidder must furnish a bid guarantee equivalent to five percent (5%) of the bid.
   6. (F) The proposal must fully explain the basis for determining the low bidder and include a statement that the contract will be awarded to the lowest responsive, responsible bidder.
   7. (G) The specifications must state that when manufacturers’ names are used they are used to establish a standard and the words or equal, if not stated, are implied.
   8. (H) The specifications must contain a provision for the maximum calendar or work days allowed for completion of the project.
   9. (I) The specifications must allow for representatives of the Department of Natural Resources to have access to the work wherever it is in preparation or progress.
   10. (J) The specifications shall require the contractor to furnish a performance and a payment bond each in an amount at least equal to 10 CSR 20-4

one hundred percent (100%) of the contract price as security for the faithful performance of his/her contract and for the payment of all persons performing labor on the project and furnishing materials in connection with the project under this contract as set forth in the standard form of performance/payment bond included in the contract documents. The surety on this bond shall be a duly authorized surety company satisfactory to the owner.

1. (K) State wage determinations must be included in the specifications.
2. (L) The specifications must include a sales tax exemption clause consistent with the Missouri State Sales Tax Law, section 144.030(15), RSMo.
3. (M) The specifications must include the following statement: “The owner shall make payment to the contractor in accordance with section 34.057, RSMo.”

1. (19) Bidding Requirements.

   1. (A) Each contract shall be awarded after formal advertising.

   2. (B) Departmental concurrence with contract award must be obtained prior to actual contract award. Recipients shall notify the department in writing of each proposed construction contract which has an aggregate value over twenty-five thousand dollars ($25,000). The recipient shall notify the department within ten (10) calendar days after the bid opening for each construction subagreement. The notice shall include:

      1. 1. Publisher’s affidavit of advertising;
      2. 2. Tabulation of bids;
      3. 3. Low bid and/or proposal the recipient

wishes to accept;

1. 4. Recipient’s recommendation of

award;

1. 5. Any addenda not submitted previous-

ly and bidder acknowledgment of all addenda;

1. 6. Copy of the bid bond;
2. 7. One (1) set of as-bid specifications;
3. 8. Missouri domestic products certifica-

tion if applicable; and

1. 9. Revised financial capability work-

sheet and certification if bids exceed prebid estimates by more than fifteen percent (15%).

1. (20) Operation and Maintenance.

   1. (A) Plan of Operation.

      1. 1. If required by the department, the

recipient of assistance for construction of mechanical facilities must make provision satisfactory to the department for the development of a plan of operation designed to assure that operational efficiency be achieved as quickly as possible. A plan of operation must be submitted by fifty percent (50%) construction completion and approved by ninety percent (90%) construction completion.

1. 2. The recipient will ensure that the

schedule of tasks as outlined in the approved plan of operation is implemented and completed in accordance with the schedules and prior to final inspection of the project. Plan of operations must be approved by the official project start-up date.

1. (B) Operation and Maintenance Manual. The recipient must make provision satisfactory to the department for assuring effective operation and maintenance of the constructed project throughout its design life. If required by the department, recipients of assistance for construction of mechanical facilities must develop an operation and maintenance. The operation and maintenance manual must be submitted by fifty percent (50%) construction completion and approved by ninety percent (90%) construction completion.
2. (C) Start-Up Training. At fifty percent (50%) construction, a start-up training proposal (if required) and proposed follow-up services contract must be submitted and approved by ninety percent (90%) construction completion.
3. (D) Wastewater Operator. The recipient must make provision satisfactory to the department for assuring that qualified wastewater works operating and maintenance personnel are hired in accordance with an approved schedule. Qualified personnel shall be those meeting the requirements established under 10 CSR 20-9.020.

1. (21) Progress Payments to Contractors.

   1. (A) It is the commission’s policy that recipients should make prompt progress payments to prime contractors and prime contractors should make prompt progress payments to subcontractors and suppliers for eligible construction, supplies and equipment costs.

      1. 1. For purposes of this section, progress

payments are defined as follows:

1. A. Payments for work in place; and
2. B. Payments for materials or equip-

ment which have been delivered to the construction site or which are stockpiled in the vicinity of the construction site in accordance with the terms of the contract, when conditional or final acceptance is made by or for the recipient. The recipient shall assure that items for which progress payments have been made are adequately insured and are protected through appropriate security measures.

1. (B) Appropriate provisions regarding progress payments must be included in each contract and subcontract.
2. (C) Retention From Progress Payments. The recipient may retain a portion of the amount otherwise due the contractor. The amount the recipient retains shall be in accordance with section 34.057, RSMo.

1. (22) Approval and Payment of Grants.

   1. (A) The applicant shall be notified by the department when the grant is awarded.

   2. (B) Payment under the grant shall be made at the request of the applicant. A payment equal to forty percent (40%) of the allowance will be made immediately after the grant is awarded and the recipient’s reimbursement request is received. Additional payments will be made in four (4) installments as follows:

      1. 1. A first installment when not less than

twenty-five percent (25%) of the construction of the project is completed based on the contractor’s pay estimates;

1. 2. A second installment when not less

than fifty percent (50%) of the construction of the project is completed and the plan of operation for the project and start-up training proposal, if required under subsection (20)(A) and (C) respectively of this rule, have been submitted and approved, and an operation and maintenance manual, as required by the department, is submitted;

1. 3. A third installment when not less than

ninety percent (90%) of the project is completed, the operation and maintenance manual if required under subsection (20)(B), has been approved and an enacted sewer use and user charge system have been submitted; and

1. 4. A fourth installment when the project

is constructed and approved by the department.

1. (C) Payments at no time shall exceed forty percent (40%) of the eligible project cost incurred at the time payment is made. Final grant amount will be adjusted downward to forty percent (40%) of actual costs at the time of the final reimbursement.

AUTHORITY: section 644.026, RSMo (Supp. 1995).* Original rule filed April 2, 1990, effective Nov. 30, 1990. Amended: Filed Sept. 4, 1991, effective Feb. 6, 1992. Amended: Filed April 14, 1994, effective Nov. 30, 1994. Amended: Filed March 1, 1996, effective Nov. 30, 1996. *Original authority 1972, amended 1973, 1987, 1993, 1995. Missouri Department of Natural Resources Preapplication For Assistance State Revolving Fund Program Applicant Information: Applicant Name: _______________________________ Address: ______________________________________ ______________________________________________ ______________________________________________ ______________________________________________ Type: Incorporated Municipality: ________________ Public Sewer District: _____________________ First Class County: _______________________ Project Manager (Local Government Official): Name: ________________________________________ Title: _________________________________________ Address: ______________________________________ Telephone: ____________________________________ Project Description: NPDES Discharge Permit Numbers of Wastewater Facilities Affected By This Project (If Applicable): _____________________ ______________________ ______________________ ____________________ Population of Area To Be Served: _____________________ Estimate of Future Population: ________________________ Other Facilities (Non-Permitted) Served: Name Population Served Type and Condition of Facility ___________________________ ___________________________________ ________________________________ Revised 8/1/91 10 CSR 20-4 This Space For Official Use Only Priority Points: Project Number: Loan Amount Requested:_________________________ _______________________________________________ Project Location:________________________________ City: __________________________________________ County:________________________________________ Legislative District:______________________________ Senate District: _________________________________ Consulting Engineer: Name:__________________________________________ Firm:___________________________________________ Address:________________________________________ Telephone:__________________________________________ Description of Problem To Be Addressed By Project Including: —Estimated volume of sewage bypassed:_________________mgd —Frequency of bypass events: ________________ per year —Description of known downstream water quality, health effects and land use: ___________________________________________ ________________________________________________________________________________________________________________ —Water body affected (Name, if known)_______________Lake ___________________Stream _______________________________ —Number of percentage of failed septic tanks: _______________Number ________________________________________% of total —Description of conditions resulting from failed septic tanks: __________________________________________________________ ________________________________________________________________________________________________________________ Other Information Regarding Problems Addressed: NOTE: A map showing facilities to be eliminated, location of bypassing, lift stations, relief sewers, Proposed Financing: SRF Loan: Applicant Contribution: Other Funding (List Source): Total To the best of my knowledge and belief, the data in this preapplication are true and correct, and the document has been duly authorized by the governing body of the applicant. Signature: ______________________________________ ___________________________ ___________________________ ___________________________ _____________________________ ___________________________ _____________________________ ___________________________ Typed/Printed Name and Title: _________________________________ Date: ________________________________